Sensitive enzyme immunoassay for the rapid diagnosis of influenza a virus infections in clinical specimens

Samples of nasopharyngeal secretion (NPS) from 100 infants and small children admitted for acute respiratory disease during the period from January to March 1989 were examined for the presence of influenza A virus. All samples were tested by enzyme immunoassay (EIA), fluorescent antibody (FA) technique and by isolation in cell culture 3–6 h after they were obtained from the patients. Of 24 influenza strains found by isolation, 21 were detected by EIA and 19 were FA⁺. In comparison with virus isolation, EIA gave the following values: sensitivity 88 %, specificity 100 %, positive prognostic value (PPV) 100 %, and negative prognostic value (NPV) 96 %. A rabbit anti-influenza-A serum (A-13) was used as catching antibody and a monoclonal anti-influenza-A pool against NP protein was used as detector antibody in EIA. A-13 gave bands corresponding to influenza A core proteins (NP and M1) in Western blot (WB) studies when different H3N2 strains were employed as antigens. A-13 gave only a band corresponding to the NP protein when H1N1 strains were examined by WB. The detection level by EIA for both H3N2 and H1N1 strains precipitated by polyethylene glycol from tissue culture maintenance medium was 1–2 ng.     

Detection of influenza A in clinical specimens and cell culture fluid by a commercial EIA

A MoAb-based capture EIA for the direct detection of influenza A from clinical samples was compared with cell culture isolation. A total of 330 respiratory specimens were submitted for detection of influenza A and/or other respiratory viruses. Influenza A was detected in 39 of 330 (12%) respiratory samples by culture or EIA. There were 33 concordant (EIA+/Culture-) samples (82%), and 6 discordant samples (3 EIA +/Culture-; 3 EIA-/Culture+). Compared to viral isolation, the EIA had a sensitivity of 92%, a specificity of 98%, with positive and negative predictive values of 92% and 99%, respectively.     

Comparative evaluation of the sensitivity of immunofluorescence methods, immunoenzyme analysis and the lectin test for the rapid diagnosis of influenza

Comparative study of the sensitivities of immunofluorescent microscopy (IFM), enzyme immunoassay, (EIA), and lectin test (LT) in the detection of influenza virus antigen in nasopharyngeal washings from patients with influenza, acute respiratory diseases, pneumonia, and laryngitis has been carried out. EIA modification (used in this study) based on the detection of a complex of viral core proteins (M + RNP) has been shown to be no less sensitive than IFM and suitable for use in the rapid diagnosis of influenza. It can be used in combination with other methods. The optimum time for collecting the washings off is day 2 from the disease onset for analysis by EIA technique and day 4 for LT.     

Use of an immunofluorescence micromethod for determining the antigens of the influenza and tick-borne encephalitis viruses

The diagnostic possibilities of several variants of the solid-phase immunofluorescent micromethod (requiring 100-200 microliter of the reaction mixture), intended for the determination of influenza virus and tick-borne encephalitis virus antigens in material obtained from patients and ticks, have been studied. A high degree of correlation between the results obtained by the methods under investigation and the control methods has been established.     

Early detection and rapid identification of Streptococcus pneumoniae and Haemophilus influenzae in acute pneumonias

The comparative study of the diagnostic value of the enzyme immunoassay (EIA), indirect immunofluorescence (IF) and countercurrent immunoelectrophoresis (CIE) was made. The serological identification of the isolated and reference pneumococci (19) and H. influenzae (38) strains revealed the possibility of using all three microanalytical methods for this purpose. The study of pneumococcal and H. influenzae antigens in native sputum obtained from 74 patients with acute pneumonia showed that EIA and indirect IF were highly sensitive, their sensitivity considerably exceeding that of the bacteriological analysis. Pneumococcal antigens were detected in 66.2% of patients by EIA and in 54.0% of patients by indirect IF, while H. influenzae antigens were detected in 58.1% of patients by EIA and in 67.6% of patients by indirect IF. The sensitivity of CIE proved to be considerably lower; in the detection of pneumococcal antigens it was level with the sensitivity of the bacteriological analysis (23.0%) and H. influenzae antigens could be detected only in 27.0% of patients.     

Antigens of Coccidioides posadasii as an Important Tool for the Immunodiagnosis of Coccidioidomycosis

Serologic diagnosis has been presented as a safe alternative for coccidioidomycosis. However, commercial kits based on coccidioidal antibodies available in the USA are considered too expensive for laboratories outside that country. In this study, we describe the preparation of antigens for detection of human coccidioidal antibodies by the immunodiffusion test (ID) and enzyme immunoassay (EIA). Antigens were tested against serum samples from patients with coccidioidomycosis, histoplasmosis and paracoccidioidomycosis, as well as healthy individuals. The highest reactivity in the ID tests was seen in the F0-90 antigen. In the EIAs, the best results were obtained with the F60-90 antigen. None of the serum samples from healthy individuals were recognized by any of the antigen extracts tested by ID or EIA. In conclusion, the F0-90 and F60-90 antigens have the potential to be commercially employed in presumptive diagnosis of coccidioidomycosis by ID or EIA, respectively. The tests could improve serological diagnosis of coccidioidomycosis in South America.     

Evaluation of the ESPLINE INFLUENZA A&B-N Kit for the diagnosis of avian and swine influenza

The ESPLINE INFLUENZA A&B-N kit was evaluated for its applicability to the rapid diagnosis of influenza in chickens and pigs. The kit specifically detected viral antigens in tracheal swabs and tissue homogenates of the trachea, liver, spleen, and colon of chickens inoculated with a highly pathogenic avian influenza virus strain, A/chicken/Yamaguchi/7/04 (H5N1), at 48 hr post-inoculation (p.i.) as well as in the tracheal and cloacal swabs and tissue homogenates of dead chickens. For those infected with a low pathogenic strain, A/chicken/aq-Y-55/01 (H9N2), antigens were detected only in the samples from tracheal swabs and organs 1-4 days p.i. The kit also detected viral antigens in the nasal swabs of miniature pigs infected with swine and avian influenza viruses. The kit was found to be sensitive and specific enough for the rapid diagnosis of infections of influenza A virus in chickens and pigs.     

Nucleic acid molecular hybridization as a method for the laboratory diagnosis of influenza: its potentials and prospects

Experiments carried out by the present moment in a number of laboratories indicate that the method of molecular hybridization (MH) has great diagnostic potential. Sufficient methodological mastery of the reaction of radioactively labeled DNA probes with RNA samples applied into a polymer membrane and good supply of commercially available materials make it possible to recommend this method for use in reference laboratories at specialized diagnostic centers. Hybridization should be used in combination with traditional virological and serological tests; the combined use of MH and the enzyme immunoassay for the determination of viral antigens permits the documentation of 90-98% of all cases of influenza A with sufficient rapidity. In the near future DNA probes for the diagnosis of influenza B and C are likely to appear. MH has rather good prospects for the analysis of experimental infection in laboratory animals, as well as for the study of the replication of influenza virus in all cultures. The prospects of the study of the processes of expression of individual genes seem to be particularly attractive. MH may play an important role as a tool for documenting vaccinal reaction, as well as for the study of the action of different chemical preparations in volunteers. And finally, the greatest expectations are linked with the use of MH for the search of inapparent (persistent, latent, etc.) forms of influenza virus infection both in experimental systems and in humans. Optimistic prospects of the studies in this field are based on high sensitivity of this method combined with its equally high specificity. An additional reserve for enhancing sensitivity is also present here due to the amplification of target molecules.     

Effective production of mouse monoclonal antibodies against influenza virus by repeated intrasplenic immunization

Two immunization techniques that enable production of mouse monoclonal antibodies were evaluated in terms of small quantities of antigen. Various amounts of purified influenza A virus particles were applied either for in vitro sensitization in cultured splenocytes or for intrasplenic immunization, followed by hybridization of the immunized cells with mouse myeloma cells. Hybridomas producing specific antibodies for influenza viral proteins were detected by enzyme-linked immunosorbent assay when more than 50 micrograms of antigens was used for the in vitro immunization method, and at least 5 micrograms was necessary for a single intrasplenic immunization. On the other hand, as little as 60 ng of antigen administered in two intrasplenic injections was sufficient to produce specific hybridomas. Two out of six randomly selected monoclonal antibodies obtained using the repeated intrasplenic immunization method were IgG and the other four were IgM. Immunoprecipitation analyses revealed that the recognized antigens involved a viral inner protein (nucleocapsid protein), as well as an envelope glycoprotein (hemagglutinin). We conclude that immunization by two direct injections of antigen into the spleen is the most effective method for sensitization with nanogram quantities of insoluble antigen such as influenza viruses.     

The immune status of children in foci of measles infection studied by an immunoenzyme method

Children immunized with live measles vaccine in the foci of measles infection varying in intensity (1-9 cases per focus) have been subjected by two methods: the hemagglutination inhibition (HAI) test and the enzyme immunoassay (EIA). As shown in this study, in most cases (98% of all blood serum samples) the correlation between the results of the HAI test and EIA is not high (r = 0.5), which is linked with the detection of a wider spectrum of antibodies in EIA. The percentage of seronegative children detected by these two methods was practically the same (4.05 and 4.4, respectively). The analysis of the results obtained in this study indicates that EIA is a more informative and sensitive method, which confirms the effectiveness of its use for the determination of the level of collective immunity.     

A new method for the detection of the H5 influenza virus by magnetic beads capturing quantum dot fluorescent signals

A new method to detect H5 influenza virus using quantum dots (QDs) and magnetic beads (MBs) is described. QDs conjugated with oligonucleotide probes were used to produce fluorescent signals and MBs, that were also conjugated with probes, were used to isolate and concentrate the signals. Target viral RNAs led to a sandwich hybridization between the functionalized QDs and MBs. One-step hybridization facilitated the subtype determination. As little as 0.1 ng viral RNA could be detected.     

Monoclonal antibodies to Mycoplasma pneumoniae antigens]

Approaches to obtaining stable mouse hybridomas, capable of producing monoclonal antibodies (McAb) to M. pneumoniae key antigens, were developed. As the result of hybridization experiments, 7 clones were obtained; of these, 4 clones stably synthesized IgG McAb. Clones H1/H9 and H9/B2 synthesized antibodies to thermolabile, proteinase-sensitive K protein, produced by cytoplasmic membranes of M. pneumoniae cells. The molecular weight of this protein was found to be 90 kD. McAb of clone H1/H9, labeled with horse-radish peroxidase and fluorescein isothiocyanate, specifically reacted with M. pneumoniae antigens in the immunofluorescence test and the enzyme immunoassay (EIA). The sensitivity of EIA was 0.25 ng/ml of antigen protein. These data are prerequisites for the development of diagnostic test systems for the detection of M. pneumoniae antigens in different biological substances obtained from patients with respiratory pathology.     

Effectiveness of methods of isolating specific class-G rabbit antibodies for the immunoenzyme determination of human placental alkaline phosphatase

Four different chromatographic methods of IgG isolation from rabbit antisera to placental alkaline phosphatase (HPAP) have been compared. The antibodies were obtained by ion-exchange chromatography and affinity chromatography on protein-A-sepharose, on the sepharose with immobilized antigen. IgG samples were characterized by the content of specific antibodies to HPAP and checked in enzyme immunoassay (EIA). IgG purified on immobilized antigen were found to be the optimal both from the point of view of the specific antibodies content and EIA sensitivity, but satisfactory results could be also obtained with ion-exchange and protein-A-chromatography purified IgG. The last two isolation methods are simpler and provide 3-10 ng/ml sensitivity of HPAP detection, which is lower, as compared with the test employing affinity antibodies (1 ng/ml), but allows the detection of HPAP in serum samples.     

Comparison of quantitative methods of DNA CMV investigation in clinical samples obtained from symptomatic and asymptomatic patients undergo renal transplantation

Cytomegalovirus infection is one of the main problem in immunocompromised patiens. Quantitative assessment of CMV load (viral load), rate of increase of load and determination of DNA level above which the likelihood of disease is high (viral load thresholdfor disease) have significant prognostic and therapeutic importance at transplant recipients. The aim of this work was the comparison of 3 quantitative molecular techniques and assessment the threshold for disease for each of them. The study was undertaken with 37 samples of serum and the whole from 17 renal transplant recipients. Part of samples (n=16) comes from symptomatic patients, and were taken in period of clinical symptoms demonstration. The samples ware investigated by hybridization method (HC) performed accordingly to Hybrid the Capture procedure, (r-t PCR) Amplicor test (COBAS AMPLICOR CMV the Monitor test) nd real time PCR (r-t PCR). In 21 out of 37 samples DNA CMV was detected by all 3 methods, 2 samples gave concordant negative results. The CMV DNA level measured by all 3 methods was significantly higher (p < 0.05; t-Student test) in samples from symptomatic patients than from asymptomatic: 4.79 versus 3.58 for HC; 3.06 versus 1.36 for PCR-Amplicor and 4.23 versus 2.88 log DNA copies/ml for r-t PCR. The threshold for disease connected with high likelihood of disease (p < 0.05; Fisher test) was established at 4 log for r-t PCR method, 4,61 for hybridization and 3 log DNA CMV copies/ml for PCR Amplicor.     

Molecular hybridization of nucleic acids as a method for the laboratory diagnosis of influenza in model experiments on cell cultures and in research on nasopharyngeal smears obtained from patients

DNA probes containing the nucleotide sequences of the conservative genes of influenza A virus (matrix, nucleoprotein and acidic polymerase genes) show their specificity with respect to the RNA of influenza A viruses in mammal tissue cell cultures (continuous spaniel kidney cell culture and primary calf kidney cell culture). The minimal amount of infected monolayer cells, permitting the detection of viral RNA, is 10(3). The results obtained in the study of nasopharyngeal washings make it possible to recommend the method of molecular hybridization for use in the epidemiological analysis in addition to virological and serological tests. The method of hybridization permits the detection of virus-specific RNA in the allantoic fluid of chick embryos in subculturing the materials under study even in those cases when hemagglutinating influenza virus cannot be isolated.     

The results of using direct solid-phase immunoenzyme analysis for assessing the specific activity of rabies vaccines

The effectiveness of the solid-phase enzyme immunoassay (EIA) in the determination of the specific activity of rabies vaccines is evaluated in comparison with that of the protective test in mice. Inactivated tissue-culture, concentrated tissue-culture and purified cerebral tissue vaccines for human use were studied. The methods for performing two EIA variants and evaluating the results are described. The average level of correlation between the results of EIA and the protective test for vaccines of different groups was revealed (0.546), the highest correlation index being obtained for tissue-culture vaccines: 0.753. On the basis of the data obtained in this study the expediency of using EIA for the determination of the specific activity of rabies vaccines has been substantiated.     

Diagnostic role of different immunologic methods for laboratory diagnostics of legionellosis

The aim of the study was a comparative analysis of diagnostic value of different laboratoty methods conducted on the basis of results of examination of patients during Legionnaires' disease outbreak in town Verkhnyaya Pyshma. Retrospective analysis of laboratory data from 74 patients with diagnosis of Legionnaires' disease was performed. Complex of laboratory methods was used (polymerase chain reaction (PCR), enzyme immunoassay (EIA), immunochromatography). In group of patients with Legionnaires' disease, the highest proportion of positive results (73%) was obtained by the EIA determining total specific antibodies in urine. Determination of antigen in urine by immunochromatographic express-test yielded 52% of positive results. PCR testing of blood specimens yielded positive results in 65% of samples but was low specific, due to that in 19% of patients from control group false-positive results were obtained. Testing of 3 autopsy samples showed that all specimens contained DNA of the causative agent. Performed analysis allowed to recommend complex use of immunochromatographic express-test of antigen detection and identification of total specific antibodies by EIA during mass people examination.